At first, Ohio State University Medical Center balked at live-tweeting a surgical procedure.

"Initially, we had some discussions about it, but we were trying to steer away from it," says Ryan Squire, the medical center's social media program
director. "We didn't think we should tweet a surgery just for publicity's sake."

That sentiment changed when three elements came together:

The hospital purchased a MAKOplasty devise, which is geared for people suffering from osteoarthritis of the knee.

Two surgeons expressed interest in live-tweeting an operation.

The hospital found a patient who was comfortable with the idea.

"Here's how we came around to the idea: We knew this kind of minimally invasive procedure could change's a person's life," Squire says. "The other
option would be a total knee replacement. We decided to tweet it, because we thought we could educate referring physicians and patients about it."

The communications team started planning out the live surgery in April. The surgery happened in June.

Not only was the surgery successful, but so were the live-tweeting and video coverage of the event on U-Stream.

"We wanted to take them inside the surgery—not just with the text, but with video," Squire says. "If you don't, it's just words floating around in
space."

OSU Medical Center posted more than 100 tweets with the hashtag #osumcmako. The tweets reached 35,000 people, and the hashtag made more than 610,000
impressions. More than 350 people watched the U-Stream video live; another 300-plus watched the archived version.

Squire says the ability to set up a live knee surgery is surprisingly easy.

"We thought about it all up front and discussed all of the potential problems and options," Squire says. "Then, you just have to get to the point where
you don't over think it—you just do it."

Inside the surgery room, there were two surgeons and three hospital communicators, including Squire. One communicator was in charge of capturing the
surgery on video while Squire supervised. Another hospital communicator worked directly with one surgeon to send tweets including the hashtag. As one
doctor performed the surgery, a second described the procedure to the communication team. This made it easier for the team to ask questions, revise
tweets and ask for suggestions.

There was also a communication team member who sat with a nurse and the family in a different room, monitoring the Twitter feed and U-Stream video. In
addition, there was also a media relations person onsite to handle any calls from journalists.

Squire says it wasn't the hospital's goal to push the surgery to patients. He said there was a PDF available about the MAKOplasty device and whom the
surgery might benefit. The team also tweeted opportunities to schedule an appointment.

"The soft-sell was more appropriate," Squire says. "It was our first Twitter surgery. And besides, if something had gone wrong—how bad would that
look?"

However, the team was prepared to handle an emergency. If something had gone wrong during surgery, the team had prepared tweets to send out to viewers
and would stop streaming the procedure out of respect for the patient.

If your hospital is thinking about live-tweeting a surgery, Squire shares three tips:

1. Tell your legal team. "We had an advocate on our legal team who understood what we were doing and we could present our plan to
them."

2. Talk to the family about an emergency plan. "Make sure they feel comfortable," Squire says.

3. Be careful with the camera's zoom button. "Nobody needed to see bone chips flying off the knee," Squire says.